HANOVER, NH - Pre-school age children who are exposed to child-targeted fast-food advertising on television are considerably more likely to consume fast-food products, according to a recent Dartmouth-led study published in the journal Public Health Nutrition.

According to the Federal Trade Commission, the greatest exposure to food advertising in the US for children aged 2-11 years comes from fast-food restaurant chains. In 2009, the fast-food industry spent more than $580 million on child-targeted marketing, with television being the predominant medium.

"In general, children's consumption of fast food is associated with increased intakes of calories, fat and sugar, making fast-food consumption an important risk factor for obesity and other health problems," says Madeline Dalton, PhD, lead author on the study, who is a professor of pediatrics at Dartmouth's Geisel School of Medicine and a researcher at the Dartmouth-Hitchcock Norris Cotton Cancer Center. "We also know that dietary practices that are formed early in life are carried throughout adolescence and adulthood."

Funded by the National Institutes of Health, the study is the first research conducted in a community setting to demonstrate a significant positive association between child-directed fast-food TV ads and increased consumption of fast food among children of pre-school age.

"Most parents won't be surprised by the study's findings since they probably know this from observing their own children, and the results are also consistent with food marketing influences that have been observed in highly controlled laboratory settings," Dalton says.

"I think what's significant about this study is we're using scientific methods we've developed over the past two decades to measure media and advertising exposure in an objective way, so that the findings are generalizable to real life and we're able to control for influences that we know are important--like parents' fast-food consumption and the overall amount of TV that children watch," she says.

In the nine-month study, the research team recruited a total of 548 parents who had a pre-school age child (average of 4.4 years) to complete a written survey during their visits to pediatric and women, infant, and children clinics in Southern New Hampshire.

Parents reported their child's viewing time, channels watched, and fast-food consumption during the past week. Their responses were combined with a list of fast-food commercials that were aired on kids' TV channels during that same period to calculate the children's exposure to child-targeted TV ads from three fast-food restaurant chains: McDonald's, Subway, and Wendy's.

The study's results show that:

-- 43 percent of the preschoolers ate food from these restaurants during the past week; a similar percentage (41 percent) had been exposed to the TV ads.

--Moderate or high exposure to TV ads increased the likelihood of consuming the fast food by about 30 percent.

--Importantly, this association was independent of the overall number of hours of TV the children watched, the frequency with which their parents ate fast food, and other factors like socioeconomic status.

--McDonald's accounted for nearly three-quarters of the TV commercials and an even greater proportion (79 percent) of the children's fast-food consumption.

According to Dalton, the findings are particularly concerning because children under six years of age can't distinguish between advertisements and programs when they're watching TV--which makes them very vulnerable to persuasive messaging. "These data provide empirical evidence in support of policy recommendations to limit child-directed fast-food marketing on TV," Dalton says.

Meghan Longacre, PhD, a study co-author and assistant professor of biomedical data sciences at Geisel, adds, "An important part of the take-home message for parents is that there are preschool channels that don't feature fast-food advertising, and to the extent that they can direct their child's viewing to those channels exclusively, they themselves can protect their children from that exposure."

While Dalton considers the findings to be "very significant," she says more research needs to be done to inform national policy around child-targeted fast-food marketing practices.

"The biggest limitation of our study is that it's cross-sectional, so we're talking about association, not causality," she explains. "The next step is a longitudinal study, which will also allow us to collect and analyze data on things like the actual food choices children make and even more precise estimates of their viewing time per channel."

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This research was funded by the National Institutes of Health, grant number R01HD071021. Co-authors on the study include: Linda Titus, PhD, Kristy Hendricks, PhD, Keith Drake, PhD, Lauren Cleveland, MS, from the Geisel School of Medicine, and Jennifer Harris, PhD, MBA, from the Rudd Center for Food Policy and Obesity at the University of Connecticut.

About the Geisel School of Medicine at Dartmouth

Founded in 1797, the Geisel School of Medicine at Dartmouth strives to improve the lives of the communities it serves through excellence in learning, discovery, and healing. The Geisel School of Medicine is renowned for its leadership in medical education, health care policy and delivery science, biomedical research, global health, and in creating innovations that improve lives worldwide. As one of America's leading medical schools, Dartmouth's Geisel School of Medicine is committed to training new generations of diverse leaders who will help solve our most vexing challenges in health care.

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